Posted by med_empowered on December 24, 2006, at 6:51:35
In reply to A LITTLE HELP HERE NEEDED! PLEASE READ!!, posted by ob1kanobee on December 24, 2006, at 2:41:23
If I were you, right now I'd focus on 2 things: 1) getting some good quality sleep and 2)stopping the panic. So...if seroquel gives you good sleep @ 25mgs, keep taking it. Take the clonazepam as needed (or daily) for panic attacks. Book a shrink appointment, or keep getting the scripts from your doctor (b/c a shrink really isn't going to do anything magical).
If you're BP II (and keep in mind a lot of shrinks overuse that diagnosis; its trendy, kind of like depression was in the early Prozac Years), then a mood stabilizer might help. If only 150mgs/Trileptal helped you in the past, I wouldn't think you were BP II; I barely qualify as BP II, and it took at least 600mgs/day to put a dent in my symptoms. What I think may have happened is the anticonvulsant action tamed your anxiety a little, especially in combo w/ your other meds. Since Trileptal is kind of expen$ive and has side effects, you might be better off doing the old school thing (benzos, maybe an AD) rather than newfangled approaches with anticonvulsants and what not. Or maybe not...some people dig the mood stabilizers for anxiety, I just think it's overkill.
One combo you could try: Benzo+low-dose AD+BuSpar, low-end dose, plus occasional sleep aid. Or you could try replacing the seroquel w/ something that will get you some more anti-anxiety mileage, like Remeron (although that could make you irritable and overweight) or some of the tricylics, like doxepin and surmontil. Lyrica (pregabalin, I think) is neurontin-ish but its potent and approved in the EU for some forms of anxiety. You might be able to take it as a sleeping pill and get some anti-anxiety benefit from it w/o having to resort to neuroleptics (at 25mgs, Seroquel is basically functioning as an extremely overpriced antihistamine; you could probably get similar results from Benadryl or Vistaril/Atarax, both of which would be much much much cheaper).
Some benzos (valium, librium, klonopin) have half lives long enough to be taken @ bedtime but still be effective during the day. One that comes to mind is Limbitrol (elavil+librium). Its apparently still used now and then...it makes a good sleeping pill for occasional use (I imagine daytime use would turn you into a Stepford Wife).
good luck.
poster:med_empowered
thread:716065
URL: http://www.dr-bob.org/babble/20061224/msgs/716090.html